Intracytoplasmic sperm injection (ICSI)

FAQs on ICSI in Los Angeles

Intracytoplasmic sperm injection (ICSI) is a micromanipulation technique. This is used along with traditional in vitro fertilization, where the woman’s eggs are combined with her partner’s sperm in a laboratory setting, and then the resulting embryo is implanted back into the uterus.

Who is a candidate for ICSI?

Intracytoplasmic sperm injection is typically used for couples who have attempted conception with no results due to a male infertility problem. Candidates for this procedure include:

• Any male with a low sperm count.
• Men who have poor sperm motility (movement).
• Any male with abnormally shaped sperm.
• Couples who have tried and failed at conception using traditional IVF.
• Men who had an unsuccessful vasectomy reversal.

What is involved during the intracytoplasmic sperm injection procedure?

During ICSI, the head of a single sperm is injected into an egg, which eliminates the requirement for sperm penetration during fertilization. The steps include:

1. Ovulation stimulation and egg retrieval – The woman is often on fertility drugs to stimulate ovulation and control egg ripening. When ultrasound confirms eggs are mature, they are retrieved using a hollow needle.
2. Obtaining sperm – The sperm is obtained by normal ejaculation for men with motility or sperm count issues. For men with other problems, surgical procedures are used to collect sperm, such as percutaneous epididymal aspiration (PESA), microepididymal sperm aspiration (MESA), and testicular sperm extraction (TESE).
3. Fertilization – After the eggs and sperm are retrieved, a single sperm is taken and inserted through the shell of the egg (zona pellicuda) and into the cytoplasm (center). Fertilization is confirmed after one day.
4. Embryo transfer – The resulting embryo(s) are then placed into the uterus through embryo transfer. To increase the probability of pregnancy, more than one embryo is usually inserted.

How much does ICSI cost?

A cycle of IVF typically costs around $7900 or more, depending on which procedures are involved. It may take more than one cycle to achieve conception. As a stand-alone procedure, ICSI costs approximately $1,500.

What risks are associated with intracytoplasmic sperm injection?

Most clinical studies show that there is no increased risk for birth defects or other problems with ART pregnancies versus natural methods. However, there are a few concerns to consider. These are:

• Weak sperm used – During normal conception, the strongest, hardiest sperm are able to fertilize the egg, which weeds out low-quality sperm. With ICSI, a weaker sperm could be selected.

• Genetic screening is required – To determine if the couple could pass on certain inherited conditions to the baby, genetic screening must be done.

• Imprinting defects – This is a phenomenon where a particular chromosome passed by the father or mother and certain genes function differently if this chromosome is passed on.

What is the success rate of the introcytoplasmic sperm injection?

The fertilization rate for ICSI is approximately 85%, according to most clinical

studies. The pregnancy success rate with in vitro fertilization with ICSI has been shown to be higher than IVF without ICSI. These rates are related to the egg quality and quantity.

The percentage of cycles that result in live births nationally are:

• 35% for those under 35 years
• 29% for those between ages 35 and 37
• 21% for those between ages 38 and 39
• 14% for those between ages 43 and 44
• 5% for those over age 44 years

What if my partner has a zero sperm count?

If your partner has a zero sperm count, the chance of retrieving sperm surgically using TESE or PESA is very low. For these patients, surgical retrieval on a “dummy run” is done. Couples who have no sperm retrieved should consider donor insemination (DI) or IVF using donor sperm.

How long does ICSI treatment take?

One cycle of IVF with intracytoplasmic sperm injection takes between four to seven weeks to complete. You can expect to be at the medical facility for two to four hours for the sperm and egg retrieval procedures. Then, you must return three to five days later for the embryo transfer process.